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Imagination and Madness

small proportion of the year having their ideas, and a lot of time editing, sorting out material, reading around, doing no new creative work at all in fact, until they have produced whatever it is. And so I wonder whether there are people who can use that cognitive fluidity, can ride it for a bit and then say, "Well, yes, but now I'm going to sit down and actually turn that into a poem or a novel or a string quartet", rather than allowing it to circulate endlessly in the mind and go off into its own loop, which might lead to all sorts of structures in the person's mind but nothing in the outside world.

Tyrrell: I agree entirely. And there is another aspect to this too and that is that a lot of these creative endeavours are fairly lonely occupations.
Years ago, I commissioned 32 brilliant illustrators for a big book I was doing for an American publisher. They were producing beautiful, very detailed illustrations. Most of these illustrators would start work at 7 or 8am and work until midnight, and didn't see other people for hours on end. Whenever I went to see them, I noticed two quite distinct reactions. Some were so quiet that they could barely talk, as if they had lost the art of conversation. Others would just talk at me for an hour or two because they were attention starved. They had the control to stick with the work they were doing, but not having human attention did seem to make their brains go a bit peculiar. We all need a certain amount of attention every day, really.

Nettle: Yes, that's probably right. And another thing to remember is that the people who produce what culture judges to be very great achievements have typically produced a lot. Mozart, Schumann —

Tyrrell: Goethe, Shakespeare —

Nettle: Yes, as well as Shakespeare's plays being extraordinary, he was churning them out extremely fast. It's a pretty hit-and-miss business being creative, and you get much better the more effort you put in. There must be a strong compulsion to continue the work, and there are many creators who say that the compulsion is almost a medical condition with them. You know, "If I weren't doing this, I wouldn't know what to do when I got up in the morning. I'd go off my head." So, for whatever reason, these are clearly people who find their creative activity something to which they become strongly attached, and it allows them to release, or work through, divergent or chaotic activity that's going on within them. Which is almost a clinical hypothesis that could be investigated further.

Tyrrell: In the conclusion of your book you have given some 'golden rules' for people who are at familial risk of schizophrenia to follow, so that they can help themselves. They really show the importance of the environment in whether people are going to have problems or not. Perhaps, if we were better at spotting and treating depression earlier, society would have far fewer psychotic breakdowns to deal with.

Nettle: Yes, I'm sure that's right. And malaise more generally – substance addiction, social phobia, anxiety and anger disorders. Being unhappy is a strong predictor of later mental and physical illness. Individuals at high familial risk for psychosis, like all of us, should manipulate their own environments so as to maximise psychological health. That is, they should choose their surroundings, their companions, and their professional challenges very carefully, if need be with professional help from effective counsellors and psychotherapists.

The golden rules are: be honest, realistic, and loving with yourself and those around you; assume a positive outlook and make brave, positive life choices, going against the grain where necessary; listen to your body and keep healthy and active; and do not tolerate niggling discontent, even for a short time, and even if it seems minor.

The niggling discontent will always out; but whereas it might lead to a broken relationship or an unhappy career for most people, for vulnerable people, it can destroy them and those who love them in the most terrifying way imaginable.

This is not just an issue for individuals. In communities and social net-
works which are fragmented, stressed, or in which there is no sense of belonging, there are poorer outcomes and higher suicide rates for the mentally ill. This is something that social policy can work on. The existence of a biological predisposition thus in no way relieves us of the responsibility for doing something about mental illness.

Tyrrell: Yes, with better, what we call, 'organising ideas', people aren't going to be so bewildered when facing these conditions as they are at the moment. For example, because of the way most counsellors and psychotherapists are trained, the way depression is treated is largely appalling.

Nettle: Yes, it is.

Tyrrell: Genetic templates are there to meet their fulfilment in the environment. Genes are, at most, only 50 per cent of the story.

Nettle: That is quite so. And neurotransmitters. People often say, "Well,
if it's a biological imbalance, only drugs can treat it", but you get a biological imbalance by sitting in a darkened room for a day.

Tyrrell: Of course! Or if someone gives you a hug, or makes you laugh, or you stretch your capabilities in some way, it changes the biology —

Nettle: Or going for a run or a swim or something. All these things are also chemical interventions.

Tyrrell: One of the really exciting things about your book is how well that comes across, particularly as summed up in the golden rules. I hope it gets the wide readership it deserves.

© Human Givens Publishing Limited and Daniel Nettle (2001)

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This article first appeared in Volume 8, No, 3 (2001) of the Human Givens journal..

DANIEL NETTLE is a lecturer in biological psychology at the Open University, in the Department of Psychology and Biological Sciences. He studied psychology at Oxford, before completing his PhD in anthropology at University College London. In 1996 he was elected a Junior Research Fellow at Merton College, Oxford. He has published many scholarly articles, as well as three books for Oxford Universiy Press: Linguistic Diversity (1999); Vanishing Voices (with Suzanne Romaine 2000); and the recent Strong Imagination: Madness, Creativity and Human Nature (£7.19)

> More information on the human givens approach and psychosis can be found in the following books both by Joe Griffin and Ivan Tyrrell

Dreaming Reality: How dreaming keeps us sane or can drive us mad

Human Givens: A new approach to emotional health and clear thinking

> You can find out more about psychosis and the new thinking on its causes at the following MindFields College events:

Understanding the mental health continuum Seminar

Psychosis: and positive strategies for Recovery Workshop